NPI | 1073128724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2020029834) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: MO 2020029834) |
Enumeration Date | 2020-09-10 |
Last Update Date | 2024-06-13 |